Provider Demographics
NPI:1063543155
Name:RUSHING, ROBERT K (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:RUSHING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-5817
Mailing Address - Country:US
Mailing Address - Phone:360-344-4248
Mailing Address - Fax:
Practice Address - Street 1:2366 EASTLAKE AVE E
Practice Address - Street 2:SUITE 326
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3366
Practice Address - Country:US
Practice Address - Phone:206-325-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB27067Medicare ID - Type Unspecified